Tummy Tuck (Abdominoplasty) Dallas

Why Tummy Tuck?

Patients desiring a flat and well-toned abdomen, try diet and exercise to accomplish this goal. However certain changes secondary to pregnancy, weight loss and aging are refractory to diet and exercise and need surgery to restore a pleasing abdominal contour. If you are considering a tummy tuck in the Dallas Fort Worth area, you may schedule an appointment to meet with Dr. Solomon, a Dallas based plastic surgeon specializing in cosmetic surgery.

Important considerations

A tummy tuck is not a substitute for weight loss.

Significant weight gain or fluctuations in weight after the procedure can results in a suboptimal result. For this reason, I only perform this procedure when the weight has been relatively stable over the last 3 to 4 months, especially in patients who have lost weight through diet, exercise or weight loss surgery.

Pregnancy after a tummy tuck will also affect the surgical results. Hence, it may be ideal to wait till after completing the family before considering this procedure. It is ideal to wait about 6 months after childbirth and attain a stable weight before considering a tummy tuck.

Stretch marks and scars up to the level of the belly button can usually be removed. However, marks outside of this area are typically shifted lower where they are less noticeable with clothing.

Although I personally perform the entire procedure including skin closure, some patients have wider scars due to differences in healing based on genetics. Good scar therapy can usually minimize these changes.

A tummy tuck is a customized procedure; you should do it for yourself and not to please someone else or fit into an ideal image.

Liposuction alone versus tummy tuck

For liposuction alone to be effective, the patient should have good muscle and skin tone, mild to moderate excess fat over the abdomen and no significant excess skin. Skin excess worsens with liposuction and patients with significant excess skin are not good candidates for liposuction alone. Beware of savvy marketing of the newer non-invasive technology that promises great results with minimal down time. There are few patients that are ideal candidates for these procedures.

Patients that need a tummy tuck fall in to one of the following categories:

  1. Mini tummy Tuck: This is ideal for excess skin and fat isolated to the lower abdomen below the level of the belly button. It also involves limited liposuction of the abdomen to remove excess fat and for contouring. Tightening of the abdominal wall muscle can also be done to attain a flatter contour to the lower abdomen.

    Limitations: Skin redundancy and stretch marks at and above the level of the belly button is not addressed. For practical purposes, few patients qualify for this procedure as most patients have areas that need to be corrected at and above the level of the belly button. Less commonly, patients with a large skin fold over the lower abdomen and mild changes above the belly button level may choose this option, as their main concern is the lower abdominal fold. Besides, this procedure is less invasive with a lower cost. In such cases, it is important to understand that there will be an unbalanced appearance between the upper and lower abdomen as only one component of the problem has been corrected.

  2. Full tummy tuck (Abdominoplasty): This procedure addresses all four components of poor abdominal contour, namely the excess skin/skin folds both above and below the belly button, excess fat over the abdominal wall, unfavorable shape/poor definition of the belly button and poor muscle tone that typically manifests as outward protrusion of the abdomen. The scar is similar to a mini tummy tuck or marginally longer and can usually be concealed beneath the bikini line. The procedure involves limited liposuction of the abdominal wall fat, removal of excess skin, reshaping of the belly button and tightening of the abdominal wall muscle in the midline from the lower chest to the pubic area to produce a flat contour most noticeable in a lateral/side view.

    Limitations: Patients with excess skin folds extending outside of the hip and into the back ideally need a belt lipectomy/circumferential body lift in addition to a full tummy tuck to address these areas. Usually the only patients that need additional procedures like belt lipectomy are those with massive weight loss.

  3. Extended tummy tuck: This is essentially a full tummy tuck with a longer incision extending over the side of the torso towards the back. The longer incision is required in some patients to produce a pleasing contour. It is sometimes not possible to conceal the outer extension of the incision within the bikini line.
  4. Skin only full tummy tuck: In a well toned person whose only complaint is excess skin/skin folds over the abdomen, no liposuction or muscle tightening is required. The excess tissue is removed through a lower abdominal incision similar to a full tummy tuck and the belly button is refashioned. No liposuction or muscle tightening is performed. Although most patients do not meet criteria for this procedure, I have had several patients who required only a skin only tummy tuck.
  5. Belt lipectomy: When skin laxity progresses outward beyond the hips and into the back, a belt lipectomy or circumferential lift is required. The scar extends all the way across the torso to the midline of the back. This procedure also produces a significant lift the outer thighs and buttocks. Patients requiring this procedure have usually lost a significant amount of weight and have skin laxity and soft tissue excess over the front and back of the lower torso.

Who is a good candidate?

These procedures are ideal for someone who is bothered by excess skin and an unshapely abdomen secondary to pregnancy, childbirth or weight loss.

Although diet and exercise can decrease the abdominal fat deposits, it cannot address excess skin or overstretched muscles. Ideally the procedure is done after completion of ones family and no more children are desired.

Post-operative recovery

Patients usually go home the same day; we recommend that you have someone with you for the first few days after surgery to help you move around, get in and out of bed, and drive you to the office for drain removal in the first week after surgery. Although results are immediate, it takes several weeks for swelling to go down. Although by 3 months the results are starting to stabilize, it takes close to 1 year for the final results to appear.

Dr. Solomon’s approach

I do a modified technique for a full tummy tuck that was first described by a Brazilian surgeon. The procedure is a significant modification of the traditional tummy tuck commonly performed in that, it preserves most of the blood supply to the abdominal wall tissue. Hence the chance of wound healing problems secondary to skin necrosis (skin at the margins of the incision line that dies as there is not enough blood supply to keep it alive) is minimal to negligible. Besides, more extensive liposuction can be performed as the technique inherently preserves more blood flow to the abdominal wall tissue.

This technique also preserves some tissue on the abdominal wall that is well supplied with blood as opposed to exposing the less vascular abdominal wall fascia with the traditional tummy tuck technique. This greatly decreases the chances of a seroma or fluid collection. All the patients shown in the tummy tuck photo gallery were operated using this technique. I have not had any patients with either skin necrosis or fluid collections in my practice.